1 research outputs found
The process of occupational therapists implementing client-centred ADL intervention in clinical practice
The overall aim: The overall aim of the thesis was to identify and describe the characteristics
of the implementation process and what hinders and contributes to the implementation of
complex interventions when occupational therapists interact with researchers. The long-term
goal of the thesis is to contribute to the development of strategies for the implementation of
complex interventions in health care.
Methods: The two studies in the thesis are based on occupational therapists’ (OTs)
experience of implementing a client-centred ADL intervention (CADL) in collaboration with
researchers within a randomized control study (RCT). In Study I, 33 OTs participated in
focus group interviews two, six and 12 months after completing a workshop before
implementing the CADL intervention to persons with stroke. By using a grounded theory
approach, it was possible to describe the OTs’ implementation process according to their
experiences of being involved in a research project. In Study II, two questionnaires with both
closed- and open-ended questions were sent out one year after participating in the workshops
and five years after the project was ended. Thirty-one of the 41 OTs responded to the first
questionnaire and 19 of 39 responded to the second. This study was a cross-sectional study,
and a convergent parallel design of mixed methods was used in order to get a broader
understanding of the OTs’ attitudes and experiences of being involved in a research project.
Findings: In the analysis of the interviews in Study I, one core category emerged: ‘The
implementation of a client-centred intervention enabled the fusion of science and practice’
and three sub-categories followed: 1) Including in the scientific world, 2) Involving as an
actor of science, and 3) Integrating in a partnership. The OTs’ attitudes towards engaging in
research were changed by support from the researchers, while the OTs acquired more and
more experience in using the CADL intervention. The process comprised of being an outsider
to the scientific world to being included and then becoming a part of the research as an
implementer of science. The findings in Study II explored the OTs’ experience after they
ended the participation in the research project. Hindrances like access to clients limited the
ability to feel safe in using the CADL in meeting with the client or when the OTs had to
update the knowledge given in the workshop. Experience of the team’s limited support was
another factor. The majority of the OTs considered support from the researchers during the
time that the projected continued to be a factor that facilitated during the implementation of
the intervention revealed both one year after participating in the workshop and five years after
the project ended. The opportunity to discuss and reflect on the role and experience as
implementers to participate in a research project contributed to changes in the meeting with
the client. The OTs felt more professional with the support of the CADL. The availability of
research-based knowledge, as relayed by the researchers, was a further factor when the
CADL intervention became a bridge between practice and science.
Conclusions: To create a context built on a collaborative partnership between practitioners
and researchers enabled the fusion of practice and science. Support from the organizations
and teams, a sufficient interaction with the researchers, a satisfying self-image, and an
accessible context were important and sustainable factors